Diagnosis

In order to assess any growths or changes in your skin, your doctor or a specialist in skin conditions (dermatologist) will conduct a medical history and exam.

History and general exam

Your doctor will conduct a general physical exam and ask you questions about your medical history, changes in your skin, or any other signs or symptoms you've experienced.

Questions may include:

  • When did you first notice this skin growth or lesion?
  • Has it changed since you first noticed it?
  • Is the growth or lesion painful?
  • Do you have any other growths or lesions that concern you?
  • Have you had a previous skin cancer?
  • Has anyone in your family had skin cancer? What kind?
  • Do you take precautions to stay safe in the sun, such as avoiding midday sun and using sunscreen?
  • Do you examine your own skin on a regular basis?

Skin exam

Your doctor will examine not only the suspicious area on your skin but also the rest of your body for other lesions.

Skin sample for testing

Your doctor may do a skin biopsy, which involves removing a small sample of a lesion for testing in a laboratory. This will reveal whether you have skin cancer and, if so, what type of skin cancer. The type of skin biopsy you undergo will depend on the type and size of the lesion.

Treatment

A number of treatments are available for basal cell carcinoma. What treatment is best for you depends on the type, location and size of your cancer, as well as your preferences and ability to do follow-up visits. Treatment selection can also depend on whether this is a first-time or recurring basal cell carcinoma.

Surgery and related procedures

Several surgical options are available for treating basal cell carcinoma. Depending on the size and location of the removed lesion, the wound may be allowed to heal on its own, stitched closed (sutured), or covered with a skin graft, a patch of healthy skin from another site on your body.

These procedures include the following:

  • Electrodesiccation and curettage (ED&C). ED&C is generally used to remove smaller or superficial basal cell carcinomas. The surgeon removes the surface of the skin cancer with a blade or scraping instrument (curette) and then sears the base of the cancer with an electric needle to control bleeding and kill cancer cells. In a similar procedure, the base is treated by freezing it with liquid nitrogen (cryotherapy) after curettage. ED&C can leave an oozing, crusty scab that usually heals within four to six weeks.
  • Surgical excision. In this procedure, your doctor cuts out the cancerous lesion and a surrounding margin of healthy skin. The margin is examined under a microscope to be sure there are no cancer cells. This procedure is used more often with larger lesions.
  • Freezing. This involves killing cancerous cells by freezing them with liquid nitrogen (cryosurgery). It's useful for cancers that are very thin and don't extend deep into the skin. This process requires a more prolonged freezing time — longer than cryotherapy with curettage — so it must be done carefully to avoid nerve damage that can result in a loss of feeling at the site.
  • Mohs surgery. During the procedure, your doctor removes the cancer cells layer by layer, examining each layer under the microscope until no abnormal cells remain. This allows the entire growth to be removed and only a very small amount of healthy tissue. This is usually an effective treatment for recurring basal cell carcinoma, a lesion on your face, and lesions that are large, deep, fast-growing or morpheaform. For aggressive cancers, this procedure may be followed by radiation therapy.

Drugs

Drugs used to treat basal cell carcinoma include the following:

  • Topical treatments. Basal cell carcinoma that is superficial and doesn't extend very far into the skin may be treated with creams or ointments. The drugs imiquimod (Aldara) and fluorouracil (Efudex, Fluoroplex, others) are used for several weeks to treat such low-risk basal cell carcinomas.
  • Medication for advanced cancer. Basal cell carcinoma that spreads to other areas of the body (metastasizes) may be treated with vismodegib (Erivedge) or sonidegib (Odomzo). These medications may also be an option for people whose cancers haven't responded to other treatments. These medications may block molecular signals that enable basal cell carcinomas to continue growing.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.

Preparing for your appointment

The following information can help you prepare for an appointment.

What you can do

  • Write down your medical history, including other conditions for which you've been treated. Be sure to include any radiation therapy you may have received, even years ago.
  • Note any personal history of exposure to excessive UV light, including sunlight or tanning beds. For example, tell your doctor if you have worked as an outdoor lifeguard or spent lots of time at the beach.
  • Make a list of immediate family members who have had skin cancer, to the best of your ability. Skin cancer in a parent, grandparent, aunt, uncle or sibling is important history to share with your doctor.
  • Make a list of your medications and natural remedies. Include any prescription or over-the-counter medications you're taking, as well as all vitamins, supplements or herbal remedies.
  • Write down questions to ask your doctor. Creating your list of questions in advance can help you make the most of your time with your doctor.
  • Find a family member or friend who can join you for your appointment. Although skin cancer is usually highly treatable, just hearing the word "cancer" can make it difficult for most people to focus on what the doctor says next. Take someone along who can help take in all the information.

Questions for your doctor

Below are some basic questions to ask your doctor about basal cell carcinoma. If any additional questions occur to you during your visit, don't hesitate to ask.

  • Do I have skin cancer? What kind?
  • How is this type of skin cancer different from other types?
  • Has my cancer spread?
  • What treatment approach do you recommend?
  • What are the possible side effects of this treatment?
  • Will I have a scar after treatment?
  • Am I at risk of this condition recurring?
  • Am I at risk of other types of skin cancer?
  • How often will I need follow-up visits after I finish treatment?
  • Are my family members at risk of skin cancer?
  • Are there brochures or other printed material that I can take with me? What websites do you recommend?

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over points you want to talk about in-depth. Your doctor may ask:

  • When did you first notice this skin growth or lesion?
  • Has it grown significantly since you first found it?
  • Is the growth or lesion painful?
  • Do you have any other growths or lesions that concern you?
  • Have you had a previous skin cancer?
  • Has anyone in your family had skin cancer? What kind?
  • How much exposure to the sun or tanning beds did you have as a child and teenager?
  • How much exposure to the sun or tanning beds do you have now?
  • Are you currently taking any medications, dietary supplements or herbal remedies?
  • Have you ever received radiation therapy for a medical condition?
  • Have you ever taken medications that suppress your immune system?
  • What other significant medical conditions have you been treated for, including in your childhood?
  • Do you or did you smoke? How much?
  • Do you now have or have you ever had a job that may have exposed you to pesticides or herbicides?
  • Do you now use or have you used well water as your primary water source?
  • Do you take precautions to stay safe in the sun, such as avoiding midday sun and using sunscreen?
  • Do you examine your own skin on a regular basis?
Oct. 05, 2016
References
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  2. Niederhuber JE, et al., eds. Nonmelanoma skin cancers: Basal cell and squamous cell carninomas. In: Abeloff's Clinical Oncology. 5th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2014. http://www.clinicalkey.com. Accessed March 26, 2016.
  3. AskMayoExpert. Basal cell carcinoma. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015.
  4. What you need to know about melanoma and other skin cancers. National Cancer Institute. http://www.cancer.gov/cancertopics/wyntk/skin. Accessed May 16, 2016.
  5. NCCN clinical practice guidelines in oncology: Basal cell skin cancer. Version 1.2016. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed March 26, 2016.
  6. ToxFAQx for arsenic. Agency for Toxic Substances & Disease Registry. http://www.atsdr.cdc.gov/toxfaqs/tf.asp?id=19&tid=3. Accessed June 2, 2016.
  7. Drugs approved for skin cancer. National Cancer Institute. http://www.cancer.gov/about-cancer/treatment/drugs/skin. Accessed May 16, 2016.
  8. Basal cell carcinoma. American Academy of Dermatology. https://www.aad.org/public/diseases/skin-cancer/basal-cell-carcinoma. Accessed June 2, 2016.